EmailMe Form - Excellence in Program Innovation:

Nominee Name

Prefix First Last

Nominee Title

Organization Name

Nominator Name

Nominator Title

Nominator Email

How long has the nominee worked within hospice or palliative care?

Please list any specialty education, training, or certification that this nominee has earned.

Please list any of the nominee's professional memberships.

Provide an essay (no longer than two pages) which includes ALL of the following:

1. The original need or problem that inspired the new program.
2. The objectives you hoped to accomplish.
3. The skills, resources or talent needed to accomplish the program.
4. Describe the steps used to implement the program.
5. How does this program measure success? What were the positive outcomes?
6. What are the practical applications for other hospices or how would other hospice and palliative care programs benefit from this best practice example?

Please note: The use of specific details will enhance the quality of your nomination.

Essay Upload

Please provide a separate essay for publication in the event program.
(150 words or less)

Please provide any additional material directly relevant to the program being nominated (manuals, brochures, forms). If having trouble uploading, please email the materials, along with the name of your nomination, to info@floridahospices.org

The winning nominations will be honored at the 2024 Awards of Excellence Luncheon in conjunction with the 2024 Forum. If your nomination is accepted, will you notify the recipient beforehand?

Yes, the nominee will be notified before receiving the award.

No, the nominee will not be told beforehand.